Seizures and Epilepsy in Cats

What is meant by a seizure or epilepsy?

A seizure, also known as a convulsion or fit, is a temporary involuntary disturbance of normal brain function that is usually accompanied by uncontrollable muscle activity. Epilepsy is used to describe repeated episodes of seizures. With epilepsy, the seizures can be single or may occur in clusters, and they can be infrequent and unpredictable or may occur at regular intervals. Some seizure disorders may be caused by organic brain disease, meaning that there is some sort of pathology in the brain, such as a tumor or an area of damage or scarring that was caused by trauma or injury.

" Idiopathic epilepsy is an inherited disorder in dogs, but is rarely diagnosed in cats."

Other forms of epilepsy may have no detectable cause, and are termed idiopathic epilepsy. Idiopathic epilepsy is an inherited disorder in dogs, but is rarely diagnosed in cats. In general, seizures and epilepsy are much less common in cats than in dogs, and in the cat, are usually symptoms of organic brain disease.

When I've spoken to other people about seizures, I've heard some unfamiliar terms. What do these terms mean?

Term

Description

Pre-ictal phase

Also called an aura - this is the change in behavior that occurs prior to a seizure (e.g. nervousness, attention seeking, head turning)

Post-ictal phase

This is the abnormal period that follows a seizure, and is characterized by a variety of signs including sleepiness, pacing, depression, excitement, excessive eating and drinking. The post-ictal phase can last for 24-48 hours in the cat.

Generalized seizures

Also called grand mal seizure, this is characterized by jerking movements, rigid limbs, paddling/running movements, loss of fecal and urinary control. The head is often bent backwards along the spine. A grand mal seizure usually lasts for 1-2 minutes.

Status epilepticus

Continuous seizures that last for more than 5-10 minutes. Cats in status epilepticus require urgent treatment.

Partial seizures

Very rare in cats. May involve only certain muscle groups or be characterized by behavioral changes (e.g. tail chasing, biting at imaginary objects, aggression).

Absence seizures

Petit mal seizure - minor seizure activity very rarely recognized in cats. Often described as "not being aware of surroundings; a brief loss of awareness."

What causes seizures?

Both diseases that involve the brain directly (intracranial) and conditions that affect other body systems (extracranial), especially liver or kidney disease, can cause seizures.

"Seizures often occur at times of changing brain activity..."

Seizures often occur at times of changing brain activity such as during excitement or feeding, or as the cat is falling asleep or waking up. Affected cats can appear completely normal between seizures.

What information can I provide to my veterinarian to help determine the cause of seizures in my cat?

By carefully observing your cat during a seizure, you can provide valuable information to your veterinarian about the types of disease that may be causing the problem.

Information about your cat's lifestyle and history may also be important, including:

What age did the seizures begin and are they getting worse?

Are the seizures intermittent or do they occur at regular intervals?

What is the frequency and duration of seizures?

Have you noticed any association between the seizures and sleep, excitement, feeding, etc.?

Are there any other signs of illness such poor appetite, excessive drinking, reduced exercise, etc.?

Has the cat received any medications or supplements recently, including any flea control products or over-the-counter deworming medicine?

What diet and nutritional supplements are given?

Has there been any access or exposure to poisons or toxins?

How can the cause of the seizures be diagnosed?

Since many different diseases can lead to seizures, it is important that diagnostic tests be performed to discover the underlying cause of the seizures. A range of tests is often needed before a final diagnosis can be made. Initially, this is likely to involve blood samples to look for extracranial causes. Following this, a general anesthetic may be required to allow x-rays of the skull to be taken and possibly to sample the cerebrospinal fluid (CSF) that surrounds the brain.

"Magnetic resonance imaging (MRI) and computer-assisted tomography (CT) can be used to look directly at the structure of the brain."

Powerful imaging techniques such as Magnetic resonance imaging (MRI) and computer-assisted tomography (CT) can be used to look directly at the structure of the brain. These specialized imaging technologies are only available at a limited number of specialist referral centers.

How are the seizures treated or prevented?

Treatment of seizures in the cat depends on the nature of the underlying disease. With recent developments in treatment, many diseases that were previously untreatable may now be treated, although this can require referral to a specialist center.

It is important that a cat having regular seizures (more than one every six to eight weeks) receives treatment even if the cause is not understood, because each seizure can lead to further brain damage and increase the likelihood of more severe seizures and complications. In cases where the cause of the convulsions is unknown or is untreatable, the seizures will need to be treated with anticonvulsant medication. The treatment chosen will depend on each individual case and specific needs. It may be necessary to adjust the dose, frequency and/or type of drug several times before the regime that suits your cat best is found. This can be a frustrating time but finding the right treatment is important for your cat's long-term well-being. Even with treatment it may not be possible to completely prevent seizures. In many cases the aim is to reduce the seizures so your cat can lead a more or less normal life.

Are there any special considerations if my cat is put on anticonvulsant medication?

"In general, once a cat is put on anticonvulsant medication, it will require this medication for life."

In general, once a cat is put on anticonvulsant medication, it will require this medication for life. It is important that you understand the following "golden rules of seizure treatment":

ALWAYS follow the instructions on the label. Both the dose and timing of the medication are important to maintain adequate drug levels in the bloodstream.

NEVER run out of the medication as sudden withdrawal of treatment can lead to uncontrollable seizures.

INFORM your veterinarian when your supply is running low so a refill prescription can be arranged. This is particularly important if the treatment needs to be ordered specially for your cat.

KEEP these drugs safe and away from children, as they can be powerful sedatives.

BE CAREFUL about other medications, including herbs and supplements, that you give your cat. If in doubt, check with your veterinarian before giving your cat anything.

What are the side effects of treatment?

Mild side effects are common, particularly at the beginning of treatment or following changes in the regime. The most common side effect is sedation or lethargy, but other signs can also occur. Most side effects are transient, and disappear as the cat becomes used to the medication. If side effects persist or seem severe, notify your veterinarian.

DO NOT CHANGE THE DOSE OR TIMING OF MEDICATION WITHOUT CONSULTING YOUR VETERINARIAN FIRST.

Why is my cat still seizuring after we started the medication?

Sometimes treatment will appear to have failed, especially during the first month or two. In many cases, this is because the dosage and timing of the medication is not yet right. The first thing you should do in this case is to check that you are following the instructions on the medication label correctly. After your cat has been on medication for several weeks, your veterinarian may take a blood sample to ensure that your cat has adequate circulating blood levels of the medication. This will allow your veterinarian to determine the appropriate adjustments.

Other causes of treatment failure include:

1. Specific circumstances such as stress - increased medication may be required during such periods.

2. Progression or worsening of the disease.

In some cases, it is not possible to control the seizures even with medication. Seizures in cats are generally a sign of significant disease; however, this does not mean that nothing can be done for your cat. With the correct treatment, the quality of your cat's life can often be dramatically improved.

This client information sheet is based on material written by: Ernest Ward, DVM